Abstract: :
Purpose: To evaluate the effect of Centrum on the developmentand progression of age–related lens opacities.Methods: The 11–center Age–Related Eye Disease Study(AREDS) included a randomized clinical trial of the effect ofhigh–dose supplementation of selected antioxidants onthe progression of lens opacity. No effect of this interventionwas observed. AREDS participants who desired a one–a–daymultivitamin supplement were provided with Centrum, an RDA–dosagesupplement. Baseline and annual (starting in year 2) lens photographswere graded at a reading center for the severity of lens opacityusing the AREDS cataract grading scale. Progression of type–specificlens opacity was defined as in the clinical trial (Arch Ophthalmol2001;119:1417–36). Because use of Centrum was electiveand therefore not randomized, a propensity score analysis wasperformed. A logistic regression model using 14 baseline characteristicswas used to generate a propensity score for Centrum use for4,590 AREDS participants with at least one natural lens present.Repeated–measures logistic regression was used to evaluatethe relationship of Centrum use and progression of lens opacityadjusted for propensity score.Results: 66% of the AREDS participants elected to supplementwith Centrum. In an unadjusted logistic regression Centrum usewas associated with a reduction in lens opacity progression(OR, 0.88; 95% CI, 0.79–0.98; P=0.022). The propensityfor Centrum use was determined without regard to outcome. Themodel yielded a c–statistic of 0.86, indicating a strongability to differentiate between Centrum users and nonusers.After adjusting for propensity score, Centrum use was associatedwith a reduction in progression to lens opacity (OR, 0.81; 95%CI, 0.70–0.94; P=0.006). The association remained presentafter further adjustment for baseline covariates age, gender,race, smoking status, education, and AMD category (OR, 0.82;95% CI, 0.70–0.95; P=0.007).Conclusion: This multicenter observational analysis of Centrumwithin AREDS suggests an association between Centrum use andlens opacity progression. The NEI is currently supporting arandomized clinical trial to assess the effect of Centrum useon the development of lens opacities.